Sarcopenia Treatment: A Guide to Muscle Strength

Sarcopenia is the progressive loss of muscle strength and mass that often accompanies ageing. It is not simply “tiredness that comes with age”: it increases the risk of falls, fractures, hospital admissions and loss of independence. The good news is that sarcopenia treatment is possible at any age, with the two tools backed by the strongest scientific evidence: resistance exercise and the right nutrition.

What sarcopenia is and how it is diagnosed

According to the revised European definition (EWGSOP2, Age and Ageing 2019), the first and most important criterion is low muscle strength. Muscle mass and physical performance then confirm the diagnosis and its severity.

In practice, the doctor uses simple tests:

• Grip strength with a dynamometer: below 27 kg in men and below 16 kg in women is considered low.
• Chair stand test: if five rises without using the arms take longer than 15 seconds, leg strength is reduced.
• Walking speed: 0.8 m/s or less indicates severe sarcopenia.
• Muscle mass measurement with DXA or bioelectrical impedance, when confirmation is needed.

For a quick check at home there is the SARC-F questionnaire (five questions on strength, walking, rising from a chair, climbing stairs and falls). A score of 4 or more means a medical assessment is worthwhile.

Why we lose muscle with age

Muscle mass declines gradually from middle age, and the loss speeds up after 60–70. Contributing factors include less movement, low protein intake, chronic low-grade inflammation, hormonal changes and the loss of motor neurons. Older muscles also respond more “sluggishly” to the protein in a meal, a phenomenon called anabolic resistance. That is why older people need a little more protein and a regular stimulus from exercise.

A hospital stay is a critical moment: a few days in bed can cost a very old person a significant amount of muscle strength. The recent guideline of the European Federation of Internal Medicine (EFIM, European Journal of Internal Medicine 2026) also highlights that some medicines, such as corticosteroids and the newer GLP-1 agonists for weight loss, may affect muscle mass in vulnerable people.

Sarcopenia treatment with exercise: the first line

Resistance (strength) exercise is the intervention with the strongest evidence. International guidelines suggest:

• 2 to 3 strength sessions a week, using resistance bands, light weights or body weight.
• Gradually increasing difficulty: when an exercise becomes easy, add repetitions or resistance.
• Balance exercises and walking, which reduce the risk of falls.
• Less sitting: every short break spent standing counts.

Simple exercises such as standing up from a chair, heel raises and seated band rows are safe for most people. Strength usually improves noticeably within a few weeks of regular exercise, while gaining muscle mass takes longer. Before starting a programme, especially with heart disease or a recent fracture, approval from the doctor and guidance from a physiotherapist are needed. You will find more ideas in our guide to gentle exercise and mobility.

Nutrition: enough protein, evenly spread

The ESPEN guideline on nutrition in geriatrics (2022) recommends at least 1 g of protein per kilo per day, adjusted to the individual. In more detail, the PROT-AGE group (JAMDA 2013) suggests:

• 1.0–1.2 g of protein per kilo of body weight per day for healthy older adults.
• 1.2–1.5 g/kg during acute or chronic illness, unless there is severe kidney failure, in which case the amount is set by the nephrologist.
• About 25–30 g of protein at each main meal, rather than all of it at dinner.

Good sources are fish, eggs, yoghurt, cheese, pulses and lean meat. A pot of Greek strained yoghurt provides about 15–20 g of protein. The Mediterranean diet, with vegetables, olive oil and fish, offers an overall protective framework. See also our basic nutrition rules for older adults.

Vitamin D calls for precision: supplements are recommended when tests show a deficiency. In older adults living at home without a deficiency, the USPSTF (2024) does not recommend it for preventing falls. Protein supplements help when food is not enough, but they do not replace exercise.

Are there medicines for sarcopenia?

There is currently no medicine approved specifically for sarcopenia. Substances such as myostatin inhibitors are being studied in clinical trials, but the foundation of treatment remains exercise and nutrition. Equally important is reviewing the medicines the person already takes and managing conditions such as diabetes or heart failure.

How ΔΕΛΦΙΝΙ helps

At the ΔΕΛΦΙΝΙ care centre in Glyfada, personalised exercise therapy and physiotherapy programmes, tailored nutrition and medical monitoring work together, so that managing sarcopenia is part of everyday practice and every resident keeps as much strength and independence as possible. Fall prevention is part of this care; see our 7 safety measures for the home.

Frequently asked questions

Is strength training safe after 80?

Yes, for most people, when the programme is adapted to their abilities and starts gently. Studies in very old people, even in care homes, show improvements in strength and walking.

How much protein does an older person need?

Usually 1.0–1.2 g per kilo of body weight per day, and 1.2–1.5 g/kg during illness. With severe kidney disease, the amount is set by the doctor.

How can I tell if my parent has sarcopenia?

Warning signs include difficulty getting up from a chair, slow walking, falls and weakness when opening jars. The diagnosis is made by a doctor using grip strength, the chair test and, if needed, a muscle mass measurement.

Does vitamin D help?

A supplement is needed when a blood test shows a deficiency, and the doctor then sets the dose. Without a deficiency, the evidence does not support that it prevents falls.

This article is for information only and does not replace medical advice. For an assessment and a personalised programme, contact ΔΕΛΦΙΝΙ.